An Endoscopic Study of Esophageal Varices

The purpose of this study was to observe the correlation between the severity of esophageal varices and various clinical findings.

Thirty-four patients with esophageal varices were selected for the study from Jan. 1981 to Sept. 1983 at the Ewha Womans University Hospital.

The varices were classified by the Sesoko's method into 3 grades according to severity. The grade I or mild varices are those with unequivocal distension and tortuosity of the vein forming fold-like elevations. The grade II or moderate varices look like hemispherical or nodular prominance in some parts of the elevated structure below the 2nd narrowing. The grade III or severe varices are the longitudinally aligned, nodular or beads-like bulging of highest degree of veins, usually throughout the entire length of the esophagus.

The observed results are summerized as follows.

1) The ratio between male and and female was 4:1. In age ditribution, the incidence was most prevalent in 4th to 5th decade.

2) Underlying liver diseases were liver cirrhosis(23 cases), carcinoma of the liver(9 cases) and chronic hepatitis(2 cases).

3) Esophagoscopy is good method for observing the variceal morphology, number, location, degree and bleeding sites in this study. Esophagoscopy is the far better method in the diagnosis of esophageal varix than esophagography. Almost the mild varices were not demonstrated by esophagography and one third of moderate varices were not detected by the routine esophagography.

4) There was no significant correlation between the size, number, location or color of the varices and variceal bleeding.

5) There was no correlation between the severity of esophageal varices and hepatomegaly. But there was a tendency for some correlation among the severity of esophageal varices, splenomegaly and ascites.